The healthcare industry has been on the frontline of the COVID-19 pandemic. Health and social care workers make up the largest proportion of key worker occupations, at 31%.[ref 1] The care industry has faced many challenges, not least in caring and protecting elderly vulnerable care home residents in a time of great uncertainty.
Healthcare operators right across the spectrum employ agency workers — employees who are contracted with a hiring agency, and are then supplied to businesses for assignment. Agency workers have been integral to care home operators during the ongoing pandemic, and also utilised as cover for staff who are self-isolating.
Agency workers will often work for numerous operators simultaneously, and can therefore find themselves working for several operators within a short period.
Considerations for Healthcare Operators
- Transmission risk: Working for multiple operators brings an increased transmission risk. Operators need to ensure agency staff are tested and monitoring all their workers with particular attention paid to agency staff that work in other settings. The use of daily COVID-19 employee risk assessments is effective, to identify issues such as symptoms and access to PPE, prior to the individuals entering the facilities. Local knowledge is also valuable in identifying potential increased risk.
- Due diligence and duty of care: Operators need to ensure that agencies are fulfilling their obligations, to ensure the suitability of staff to care for patients. Pre-duty checks need to be conducted and made available to both operators and the agency, to allow an informed decision to be made. With greater duty of care to patients, operators need to reflect this in selecting an agency, and share the responsibility of duty of care.
- Staffing restrictions: The issue of self-isolation could result in a further shortage of workers. Employees could find themselves exposed to increased physical and mental exhaustion. Operators need to collaborate effectively with agencies to ensure statutory obligations to both patients and working staff are met.
- Training requirements and procedures: Different healthcare operators will have different procedural requirements. This could be number of employees required for lifting patients, or in the use of medical equipment. It is also important to maintain basic Care Quality Commission Health and Safety requirements. Operators need to clearly define and communicate requirements to employees, and collaborate with agencies to confirm statutory obligations to ensure the safety of their workers and the patients of the operators.
- High turnover of agency staff: The high churn seen in the sector makes both training and monitoring standards more of a challenge. Operators may need to reassess how to make training more effective and succinct to reflect this.
- COVID-19 related claims: The use of agency workers has implications for operator's risk assessments for claims arising from both Employers Liability and Public Liability. There is also a significant potential impact for Medical Malpractice claims if staff are overworked or not trained to a sufficient standard. Operators need to work with their broker to clearly understand their liability exposure and how to mitigate it.
- Overreliance on agency staff and talent attraction: This is likely to leave both regulation and quality risk for operators, who will need formulate a plan to better attract a permanent workforce. A challenge for both the NHS and the private sector, employing staff on permanent contracts will likely have positive effects from both a cost perspective (the elimination of agency fees) and service standard monitoring.
Patient, service user, and employee safety is of paramount importance in this uncertain time. Healthcare operators need to collaborate with agencies to ensure the duty of care is shared. With the nature of agency work, the line of liability is somewhat blurred, but working together effectively is going to be key to protecting those in the care sector in the ongoing pandemic.
1 Source: Office of National Statistics